The 4 Waves of the Opioid Crisis

Wave 1: Prescription Opioids

Pain labeled the “Fifth Vital Sign.”

Body Temperature, Blood Pressure, Heart Rate, Respiratory Rate, +Pain

Doctors pushed to prescribe more.

Patients expected meds for any pain score 4+.

Wave 2: Heroin

Patients cut off from prescriptions turned to the streets.

Heroin use skyrocketed.

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Wave 3: Illicit Fentanyl

Fentanyl replaces or boosts heroin.

Far deadlier, far cheaper, and now sought out on its own.

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Wave 3: Gas Station Heroin

Lab-made synthetics sold as “safe.”

Designed to mimic the intoxicating and dissociative effects of scheduled drugs.

No age limits. No prescriptions. No oversight.

Marketed to kids, vulnerable users, and people seeking relief.

$26B+ black market and growing fast.

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